anal fissure

A painful linear ulcer on the margin of the anus. It is a common problem in infancy and fairly common in constipated adults.

Patient care

Conservative, nonoperative care heals most anal fissures. Patients should be advised to drink a lot of water to lubricate stools, adopt a high-fiber diet, and take a stool softener to ease the passage of stool. Sitting in a warm bath several times a day may help relax the anal sphincters. Medicated creams or ointments may provide topical anesthesia to the anus.

Patients who do not improve with medical therapies may require local injection of botulinum toxin to relax the sphincters or surgery to repair chronic fissures.

Although none of these findings are specific, the combination of poorly defined nodules, fissural nodularity and a bronchovascular distribution of perihilar opacities on CT is highly suggestive of pulmonary KS [29].

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